Individual provider Active NPI

Berta Rodriguez-Diaz

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1336507433
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9550251-6004 Issued in UT
Practice address
5770 S 1500 W
Salt Lake City, UT 84123-5216
Phone
(801) 265-3412
NPI assigned
Feb 3, 2016
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9550251-6004 UT Primary

Addresses

Primary practice location

5770 S 1500 W
Salt Lake City, UT 84123-5216

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (888) 949-4864

Other practice location 1

100 S 1000 W
Tooele, UT 84074-4010
Phone (888) 949-4864

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250121001670 UT Practitioner - Mental Health Counselor 0547799561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3610 S 1000
Salt Lake City, UT 84119-7829
Phone (801) 288-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Canyon Counseling PLLC Mental Health Current Accepting new patients
Valley Behavioral Health Incorporated CurrentSince Sep 5, 2025 Accepting new patients
Valley Mental Health Incorporated Current Accepting new patients
Horizons Counseling & Wellness Center CurrentSince Jan 1, 2025 Accepting new patients
Valley Mental Health Incorporated Mental Health PastSince Aug 25, 2025 Accepting new patients

Locations

4695 S 1900 W
Ste 6
Roy, UT 84067
Phone (801) 931-0488

4460 S Highland Dr
Ste 230
Slc, UT 84124
Phone (801) 263-7227

4460 S Highland Dr
Slc, UT 84124
Phone (801) 263-7101

66 W Vine St
Ste 1
Tooele, UT 84074
Phone (435) 241-4920

100 S 1000 W
Tooele, UT 84074
Phone (435) 843-3520

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1336507433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "888-949-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 S 1500 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235216",
            "telephone_number": "801-265-3412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S 1000 W",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840744010",
            "country_code": "US",
            "telephone_number": "888-949-4864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ-DIAZ",
        "first_name": "BERTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "9550251-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.